| NPI | 1023461100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX S0202) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 65510) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2024-02-13 |